Heart Failure and Neurocognitive Disorders: A Narrative Review.

Abstract

Neurocognitive disorders-including mild cognitive impairment, dementia, and delirium-are common yet often underrecognized in heart failure, impairing self-care and outcomes. These heart failure-related neurocognitive disorders pose a significant public health challenge due to high morbidity and mortality. Despite recent advances, timely detection, prevention, and intervention remain difficult. Most research focuses on pharmacological treatments, with limited attention to nonpharmacological approaches and mental health integration in heart failure care teams. Progress requires collaboration among internal medicine, surgery, nursing, and psychology. This review highlights interconnected pathways-cerebral hypoperfusion, microvascular and endothelial dysfunction, thromboembolic injury, and neuroendocrine-inflammatory activation-and discusses targeted interventions like simplified treatment plans, caregiver involvement, and multidisciplinary referrals.